Diffuse Large B Cell Lymphoma
Diffuse Large B Cell Lymphoma is an aggressive non-hodgkin's lymphoma, NHL. Diffuse Large B Cell Lymphoma often presents as a gastrointestinal tumour with symptoms reflecting its location. Common sites include the stomach, intestine, but also the spleen and liver similar to other lymphomas.
In patients with Diffuse Large B Cell Lymphoma, one must do complete staging. This includes a computed tomogram of the lung and abdomen, as well as a Gallium Scan, MUGA, and bone marrow looking for involvement. As the lymphoma consists of B cells, flow cytometry identification of CD-20 positivity could then allow an oncologist to add rituximab as a treatment. Rituximab has shown to have a more dramatic response in patients who are Bcl-2 positive, which is a protein invloved in apoptosis, which is programmed cell death.
Flow cytometry is a tool that is indispensible with lymphoma diagnosis and progrmosis. CD10, Bcl-6 positive cells signify good prognosis. Bcl-2 positive cells depict poor prognosis. If the bone marrow revels clonal proliferations of the B cells, and diffuse involvement, there is a worse prognosis for the patient, as there may be pancytopenia, as the other cell types may have decreased. These inidividuals need more aggressive chemotherapy. CHOP plus rituximab have however, been shown to have a 80% cure rate, with a possible additional treatment as many patients relapse the first time.